Boulder Community Health Lighting Study

Boulder Community Health Lighting Study

A 24-Hour Light Cycle Built to Support the Body's Own Clock

BACKGROUND & SCALE

Light as Part of the Treatment Plan

Boulder Community Health's Della Cava Family Medical Pavilion houses the region's only adult inpatient Behavioral Health program, along with electroconvulsive therapy and an adult counseling center. When the unit moved from its original 1992 facility into newly constructed space in April 2019, it grew from 10,758 to 17,622 square feet and consolidated what had been a mix of private and semi-private rooms into 18 all-private beds — but the more distinctive shift was overhead. During early design, the team ran goal-setting workshops with unit staff and BCH leadership and came away convinced the lighting itself deserved to be part of the treatment plan, not just an amenity. The result: The new unit became the first known inpatient behavioral health facility to incorporate tunable lighting throughout its entire footprint, from common areas to patient rooms, bathrooms, and staff offices.

Behavioral health patients often stay for days or weeks—the average stay at this unit is about six days, though it can run to months—frequently with limited access to the outdoors and, as a result of their condition or treatment, disrupted sleep-wake patterns to begin with. The design team's premise was straightforward: if light itself can influence circadian rhythm, mood, and a patient's sense of time passing, it was worth engineering deliberately rather than leaving to a standard fluorescent fit-out.

DESIGN APPROACH

Engineering a Building-Wide Circadian Signal

BA organized the lighting strategy around three goals: elevating patient experience, supporting staff health and performance, and advancing the organization's broader ambitions around innovation and sustainability. Meeting all three with one system was demanding. The tunable program itself—developed in dialogue with ZGF Architects' work on Seattle's Swedish Behavioral Health unit—shifts gradually across seven presets over a 24-hour cycle, roughly five minutes per transition, minimizing blue-spectrum light at night and building it back in through the morning and midday. Transition times were deliberately locked to the unit's daily activity schedule rather than the seasonal clock, so the same lighting cues repeat every day regardless of time of year, reinforcing routine for patients who can otherwise lose track of it.

Getting there took real technical effort. The system ultimately relied on roughly thirty different luminaire types across five product lines in patient rooms alone, every one of which had to be simultaneously anti-ligature, non-institutional in appearance, matched in color temperature range, and able to talk to the same control protocol — a narrow intersection of requirements that took considerable time working directly with manufacturers to satisfy. Patients were given three separate lighting zones in their rooms plus two more in the attached bathroom, with manual override of intensity (though not the automated color shifts), while amber step-lights along the floor gave staff enough visibility for nighttime checks without waking patients. The effort tracked with BCH's broader identity: the health system was the first hospital in the US to earn LEED certification in 2003, and an efficient, dimmable LED system fit squarely within that sustainability commitment.

RESEARCH & VALIDATION

Testing the System Against a Year of Real Data

Research question: How does the lighting in an inpatient behavioral health unit impact staff and patients?

Rather than treat the lighting system as a design assumption, BA partnered with Pacific Northwest National Laboratory, with funding from the U.S. Department of Energy's Lighting R&D Program, to study it rigorously enough to publish. Staff wore LYS wearable light sensors clipped to their collars across three measurement phases—the old unit in December 2018, a static-lit baseline in the new unit through spring 2019, and the fully tunable new unit in January 2020—while the team also logged every button press at lighting control stations throughout the unit for 243 consecutive days.

The middle phase hit a snag when a technical fault briefly and unintentionally activated the tunable program early in May 2019, forcing the team to discard a month of compromised data and recommission the system before resuming; the final measurement period was then deliberately timed to fall almost exactly one year after the original baseline, so both phases saw nearly identical hours of daylight. After cleaning, the study retained more than 104,000 light readings from the old site and roughly 88,000 from the new one, alongside stationary measurements taken at six fixed points before the unit was ever occupied. The findings were published in the peer-reviewed Health Environments Research & Design Journal in 2023, following an earlier presentation at NatCon 2021.

WHAT WE LEARNED

The System Held Up

The wearable data confirmed the design intent: color temperature swung far more widely across the day in the new unit than in the old one, tracking the programmed daily rhythm, while the old fluorescent system stayed nearly flat around the clock. Illuminance levels were actually somewhat lower on average in the new unit, a reminder that a more sophisticated system isn't automatically a brighter one—it's a more deliberately calibrated one.

The control-station data added something the earlier poster couldn't: direct evidence of how people actually used their autonomy. Patients interacted with their in-room controls regularly, averaging 10 to 15 button presses a day and, in some rooms, spiking to as many as 200 in a single day—clear confirmation that the manual override wasn't a feature going unused. Two rooms saw almost no activity at all, a useful signal that they were rarely occupied. Staff told a different story: nurses at the primary nursing station touched their controls only a few times a day on average, suggesting the automated program was largely meeting their needs without intervention. The one conspicuous exception was the security office, where staff manually overrode the automatic lighting changes on 88% of occupied days, almost always within minutes of a scheduled transition—a clear, specific signal for where the programmed schedule didn't quite match how that space actually gets used, and a concrete target for recalibration.

PARTNERSHIP & KNOWLEDGE-SHARING

Turning One Project into a Field-Wide Resource

The study's methodology—pairing wearable sensors with lighting-control usage data—was itself a contribution to the field, offering a more holistic picture of occupant light exposure than prior behavioral health lighting research had achieved. That rigor is what carried the work from a conference poster to a peer-reviewed paper in the Health Environments Research & Design Journal, giving the findings a level of scrutiny and permanence in the literature that most project case studies don't reach. And the research relationship didn't end here: the same PNNL research team went on to apply similar lighting-control data methods to a NICU patient-room study, extending the approach this project helped pioneer into an entirely different care setting.